a) Field of the Invention
The invention is directed to a medical instrument for the directed placement of a knot formed by two free ends of a surgical thread of like suture material accompanied by formation of a continuous loop.
b) Description of the Related Art
In medical practice, tissue, organs and the like are frequently joined by means of surgical thread by passing the thread through the tissue or looping it around the organ and then tightening the loop by means of a knot until the tissue or organ is held in the desired position. Often, an additional knot is then tied on the first knot in order to secure this position. Placing the knot is very difficult in particular when the suture line is poorly accessible. Placing the knot is especially problematic when operating within a closed space. For this purpose, after the loop is placed through the tissue or organ, the two free ends must be guided out of the body via a trocar and then knotted. An instrument is then used to move the knot through the trocar to the suture line while the free ends of the thread remain outside the trocar. Known instruments for sliding the knot have a long shaft having a holder or the like for the knot arranged at one end. The holder is guided to the knot between the two free ends of the thread until the knot is received therein or held in some other manner. The knot is then slid, first within the trocar and then within the body cavity, until reaching the suture line. Handling of the knot and the free ends of the thread is not always exact. Sometimes the knot or the ends of the thread cannot be held securely by the instrument and are lost so that the ends must be knotted again and the sliding of the knot must be repeated. A particular drawback consists in that the knot can, at best, be slid, but not placed and tightened in an exact manner.